Certificate of Need (CON) emerged as a central issue during West Virginia's recent legislative session, with substantial efforts to eliminate the system ultimately falling short. The CON reform has been a longstanding policy debate in West Virginia, but it’s one that has gained unprecedented momentum over the last year. Throughout my various roles – from Commerce Secretary to Senior Counsel under Governor Justice to legislative work – I have witnessed the cyclical nature of CON reform discussions. However, this year marked a significant shift in the political landscape.
For the first time in recent history, the repeal of CON became an explicit gubernatorial priority. Governor Patrick Morrisey elevated the issue to a cornerstone of his legislative agenda, generating broad legislative support for elimination efforts. This executive-driven effort represented a notable departure from previous reform attempts that lacked such high-level backing.
The legislative focus centered on House Bill 2007, introduced at the Governor's request. This comprehensive measure would have dissolved the West Virginia Health Care Authority, the regulatory body responsible for administering the CON program through capital expenditure approvals for covered healthcare services. The bill was narrowly defeated in the House Health and Human Resources Committee, falling by a single vote at 13-12. This defeat and the surrounding debate highlighted both the growing momentum for reform and the strong continued support that remains.
Despite the failure of H.B. 2007 and other legislative vehicles, Governor Morrisey has publicly committed to continuing his reform efforts, ensuring the issue remains politically active beyond the regular session.
In another unprecedented aspect of this policy debate, the issue’s relevance now extends beyond legislative chambers into administrative action. Rather than allowing the issue to remain dormant until next year’s legislative session, Governor Morrisey has taken executive action on the issue. The Governor has overhauled the leadership of the Health Care Authority. The appointment of Gordon Lane as acting Executive Director, who previously served as the Authority's general counsel since October 2024, signals a shift toward internal reform.
More significantly, the Governor has appointed three new members of the five-member Authority. These new members include:
- Heather Glasko-Tully – A former House of Delegates member and Vice Chair of the House Health and Human Resources Committee, Tully contributes extensive clinical experience as a Family Nurse Practitioner with FQHC background, and 13 years of ICU nursing experience.
- Doug McKinney – A retired physician with 10 years as Chief of Urology at Clarksburg VAMC, national policy experience through the American Urological Association's Health Policy Committee, and organizational leadership as former President of both the West Virginia State Medical Association and WVU Medical School Alumni Association.
- Robert Cheren – An attorney currently serving as Senior Counsel at Empower Oversight, with previous service as Special Assistant to the West Virginia Attorney General.
This strategic reconstitution of the Authority suggests that CON reform efforts will continue through administrative channels. The new leadership composition positions the Authority to potentially reinterpret its regulatory approach. Stakeholders in West Virginia's healthcare system should recognize that the Health Care Authority retains substantial regulatory influence over the CON framework. The political dynamics have shifted from purely legislative reform to a dual-track approach combining continued legislative pressure with administrative restructuring. Effective engagement will require direct communication with both the reconstituted Authority and the Governor's Office, as this new leadership team redefines the state entity's operational priorities and regulatory philosophy.
James M. Bailey is a Member; Co-Chair of Government Relations Practice Group; Chair of Business Expansion and Development Practice Group; Chair of Government Contracts Practice Group.
